If your loved one has Alzheimer’s disease, what they can and can’t remember may seem confusing to you. They may not remember what day it is, or even what season, but they can recall a trip they took a half-century ago in detail.
What’s happening with their memory? And how can you support them? It’s crucial to understand that living in the past is part of the disease process, so you can support your loved one and find ways to communicate with them.
We connected with Po-Heng Tsai, MD, a neurologist with Banner Alzheimer’s Institute, to learn more about why people who have Alzheimer’s disease might live in the past.
“Memory loss is a common symptom of Alzheimer’s and other dementia,” Dr. Tsai said. “But we believe the brain has different memory systems. For example, we have seen people with dementia who do not remember what they had for breakfast but could still remember how to play piano beautifully.”
“People with Alzheimer’s disease often revisit the past because the disease affects the part of the brain responsible for forming and holding recent memories. So people rapidly forget recent information and events. But remote, old memories are stored in other parts of the brain that have not been affected by the disease,” Dr. Tsai said.
The power of older memories
Older memories are often nostalgic. They have emotional meaning. They may feel warm, familiar, secure and comfortable for people with Alzheimer’s.
Even if details of the memories fade, the emotions may remain. Scents, sounds or objects may trigger nostalgic memories. As problems with memory and thinking get worse, positive emotions can help a person with Alzheimer’s disease have a better quality of life.
Older memories can link people to a time when they felt more stable, especially as they are dealing with the challenges of dementia caused by Alzheimer’s. If they find it hard to express their emotions in the present, revisiting memories can give them an outlet for their feelings.
How connecting with the past can help
Reminiscence therapy, which taps into long-term memories, may help improve quality of life for people living with Alzheimer’s disease. Reminiscence therapy focuses on remembering and talking about past experiences. It helps people with Alzheimer’s disease stimulate their brains and feel connected and comforted
It also helps people build their identity, since they are anchored in a history that’s separate from the challenges of dementia.
As a caregiver, you can tap into the emotional strength of memories to create meaningful moments. You can talk about past experiences or share activities that bring up memories. Here are some things you may want to try, based on what your loved one is interested in:
- Look at old recipes or cook or bake together
- Flip through photo albums
- Rewatch a favorite movie
- Encourage them to share stories from the past
- Listen to music or play musical instruments
- Work in a garden
- Visit places that used to be part of their routine
- Create customized memory books with photos, souvenirs and stories
- Plan visits with small groups of family members or friends
How to communicate with your loved one when they are living in the past
Communication depends on how much your loved one understands. “For people who know they have a memory problem and tend to relive the past memories, reassure them that it is not their fault, but a reflection of the changes that are going on in their brain,” Dr. Tsai said.
“For people who do not have these insights, reliving past experiences frequently results in retelling the same stories from the past, which is often bothersome or distressing to their care partners,” he said.
Understanding how the disease is affecting your loved one can help you be more empathetic. “Take a deep breath and realize they are not doing this on purpose,” Dr. Tsai said. “Be brief, clear and gentle in your interactions.”
If they keep asking you the same question, answer and respond the same way every time. “You could even write your response down, post it in a central location and direct them to read it,” Dr. Tsai said.
When you’re communicating with a loved one who has Alzheimer’s disease, it can help to:
- Maintain eye contact
- Nod, smile and respond
- Use simple language
- Speak in a gentle tone
- Limit distractions
- Ask yes or no questions
- Use visual cues and positive body language
- Empathize with their emotions
- Be patient
You can also validate their emotions, even if you can’t change their situation. If what they perceive doesn’t match with reality, support their feelings instead of correcting them. Join them in what they are experiencing. Correcting them may make them feel stressed or anxious.
“Sometimes people not only revisit the past, but they could mix up different events or even relate events that are simply not true. They may seem to be living in a different reality. If this happens, avoid correcting the memory, presenting ‘other’ evidence or orienting them to your reality,” Dr. Tsai said.
If they are upset, you can try to distract them by redirecting them to a more positive or calm subject. Being calm yourself can help. Use a soothing voice and touch them gently if you think that will reassure them.
The bottom line
It’s common for people who have Alzheimer’s disease to relive the past. That may be because the memories from the past are stored in a different part of the brain than recent memories, and they often are attached to strong emotions. You can support your loved one by encouraging them to share their past experiences, since they may feel comforted by these memories.
For more ideas, strategies and support for caring for someone with Alzheimer’s disease or dementia, listen to the Banner Health podcast Dementia Untangled.
To connect with support for yourself or a loved one with Alzheimer’s disease, reach out to an expert at Banner Health.
